BACKGROUND: Hypotension occurs frequently after epidural anesthesia. Intravenous fluid or vasopressors are among treatment methods to many suggested causes. This study was undertaken retrospectively to determine if the age, weight and height of parturients are related to the local anesthetic dosage in epidural anesthesia for the cesarean section, and if the dosage of local anesthetic influence the change of blood pressure and the requirement of fluid or epherine. METHODS: Sixty-nine parturients were studied by reviewing patients' anesthetic records. During lumbar epidural anesthesia to T4 sensory level, all patients were monitored with mean arterial blood pressure, and prevented from hypotension by administration of Ringer's lactated solution. But if hypotension has been sustained in spite of rapid fluid loading, intermittent ephedrine was injected. We studied the correlation of local anesthetic dosage, decrement of mean blood pressure and total required intravenous fluid volume, and difference of these variables between cases using ephedrine and not using. RESULTS: The volume of local anesthetic to achieve a T4 sensory level was 21.20 3.81ml, which did not correlate with age, weight and height, and did not influence the decrease of mean blood pressure and the volume of administered fluid. But the patients (n=30) who needed ephedrine were adminstered significantly larger dose of the local anesthetic and showed more decrease in the mean blood pressure than those (n=39) who did not. CONCLUSIONS: The dose requirement of local anesthetic during epidural anesthesia for the cesarean section is not determined by the age, weight and height of parturients. But when larger dose of local anesthetic is administered, the patients seem to be more hypotensive and need ephedrine as well as intravenous fluid administration.
Anesthesia, Epidural* ; Arterial Pressure ; Blood Pressure ; Cesarean Section* ; Ephedrine* ; Female ; Humans ; Hypotension ; Pregnancy ; Retrospective Studies

Osteochondritis usually occurs in the epiphyseal center of children. Common sites of involvement of osteochondritis are the femoral head, tarsal navicular, talus, lunate, but the patellar involvement is rare. The exact cause of osteochondritis is unknown but it is believed to be traumatic or nontraumatic (idiopathic) in origin. This disease was first described by Kohler in 1908 and characterized by radiographic finding of increased density in the patella We have experienced here one case which is believed to be osteochondritis of the patella.
Child ; Head ; Humans ; Osteochondritis ; Patella ; Talus

Clinical observation was made on 131 cases of the unstable spine injury treated at the Orthopedic Surgery Department of Busan National University Hospital during the period from January 1974 to December 1981. The results obtained were as follows: 1. More than two-thirds of patients were between the age of 20 and 40, and the proportion of males to females showed a ratio of 5.9 to 1. The most common cause of injury was falling at an industrial area, rating 64.1% of all cases. 2. Fracture level was observed 31.3% in the first lumbar level, 24.4% in the twelfth thoracic vertebra, and 67.9% between the twelfth thoracic vertebra and the second lumbar vertebra. 3. Mechanisms of injury were 44.3% by pure flexion, 26.7% by flexion and rotation, 15.3% by direct shearing force, and 13.7% by vertical compression. 4. The fracture with lower extremity paralysis was due to the rotational fracture dislocation, which comprised 66% of all. 5. Kyphosis increased to the average of 10.6 degree in the case of decompressive laminectomy and of 3.4 degree in the case of spinal fusion. 6. The anatomical alignment and a definite stability could be obtained by the use of Harringtons rod in the cases of the unstable thoracolumbar fracture and fracture-dislocation. In 3 cases of all, we could get satisfactory results 1 month after the day injury occured. 7. In case of complete paralysis of lower extremity, it was found only 9.4% showed partial recovery, neurologically, and 61.9% of the patients with incomplete paralysis were also partly recovered. 8. The most common complication was urinary tract infection, which comprised 83% of the cases. With the use of intermittent urinary catheterization, the voiding reflex recovered within 4 months in most cases.
Accidental Falls ; Busan ; Dislocations ; Female ; Humans ; Kyphosis ; Laminectomy ; Lower Extremity ; Male ; Orthopedics ; Paralysis ; Reflex ; Spinal Fusion ; Spine ; Urinary Catheterization ; Urinary Catheters ; Urinary Tract Infections

STUDY DESIGNS: A retrospective study. OBJECTIVES: To analyze the clinical and radiological outcomes of spontaneous reduction via minimally invasive transforaminal lumbar interbody fusion (Mini-TLIF) as the treatment for low-grade symptomatic spondylolisthesis. SUMMARY OF LITERATURE REVIEW: Although minimally invasive transforaminal lumbar interbody fusion is technically demanding, this procedure is an effective method for spontaneous reduction of low grade spondylolisthesis. MATERIALS AND METHODS: We analyzed consecutive series of 41 patients with low grade spondylolisthesis who underwent minimally invasive transforaminal lumbar interbody fusion, between April 2008 and July 2009. The minimum follow-up period was 2 years. Clinical evaluation was performed by an analysis of Visual Analogue Scale and Oswestry Disability Index. For the radiological evaluation, disc space height, slip percentage, and slip angle were analyzed. At the final follow-up, the fusion rate was analyzed according to the Bridwell's anterior fusion grade. RESULTS: For the evaluation of clinical outcomes, the Visual Analogue Scale for back pain decreased from 6.8+/-1.2 to 2.0+/-1.1, and that for radiating pain decreased from 7.9+/-1.3 to 1.7+/-1.1. Oswetry Disability Index decreased from 38.5+/-8.4 to 13.4+/-6.1. For the radiological evaluation, disc space height increased from 8.4+/-2.14mm to 11.8+/-1.54mm(P<0.05), slip percentage was reduced from 18.4+/-5.1% to 13.3+/-3.1%(P<0.05) and slip angle decreased from 10.6+/-4.5degrees to 6.2+/-3.4degrees (P<0.05). At the final follow-up, radiological union was obtained in 38 cases (92.7%). CONCLUSIONS: We conclude that minimally invasive transforaminal lumbar interbody fusion appears to be an effective method for spontaneous reduction of low grade spondylolisthesis if the surgeon becomes familiar with this method.
Back Pain ; Follow-Up Studies ; Humans ; Retrospective Studies ; Spondylolisthesis

No abstract available.
Mesothelioma*

STUDY DESIGN: This is a retrospective study that was done according to clinical and radiological evaluation. PURPOSE: We analyzed the clinical and radiological outcomes of minimally invasive transforaminal lumbar interbody single level fusion. OVERVIEW OF LITERATURE: Minimally invasive transforaminal lumbar interbody fusion is effective surgical method for treating degenerative lumbar disease. METHODS: The study was conducted on 56 patients who were available for longer than 2 years (range, 24 to 45 months) follow-up after undergoing minimally invasive transforminal lumbar interbody single level fusion. Clinical evaluation was performed by the analysis of the visual analogue scale (VAS) score and the Oswestry Disability Index (ODI) and the Kirkaldy-Willis score. For the radiological evaluation, the disc space height, the segmental lumbar lordotic angle and the whole lumbar lordotic angle were analyzed. At the final follow-up after operation, the fusion rate was analyzed according to Bridwell's anterior fusion grade. RESULTS: For the evaluation of clinical outcomes, the VAS score was reduced from an average of 6.7 prior to surgery to an average of 1.8 at the final follow-up. The ODI was decreased from an average of 36.5 prior to surgery to an average of 12.8 at the final follow-up. In regard to the clinical outcomes evaluated by the Kirkaldy-Willis score, better than good results were obtained in 52 cases (92.9%). For the radiological evaluation, the disc space height (p = 0.002), and the whole lumbar lordotic angle (p = 0.001) were increased at the final follow-up. At the final follow-up, regarding the interbody fusion, radiological union was obtained in 54 cases (95.4%). CONCLUSIONS: We think that if surgeons become familiar with the surgical techniques, this is a useful method for minimally invasive spinal surgery.
Follow-Up Studies ; Humans ; Retrospective Studies

PURPOSE: To assess changes in lower urinary tract symptoms (LUTS), prostate volume, and serum prostate-specific antigen (PSA) after discontinuation of 5-alpha reductase inhibitor (5ARI) combination therapy in patients with benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: From December 2003 to December 2012, data were collected retrospectively from 81 men more than 40 years of age with moderate to severe BPH symptoms (International Prostate Symptom Score [IPSS]> or =8). The men were classified into group 1 (n=42) and group 2 (n=39) according to the use of 5ARI therapy. A combination of dutasteride 0.5 mg with tamsulosin 0.2 mg was given daily to all patients for 1 year. For the next 1 year, group 1 (n=42) received the combination therapy and group 2 (n=39) received tamsulosin 0.2 mg monotherapy only. The IPSS, prostate volume, and PSA level were measured at baseline and at 12 and 24 months according to the use of dutasteride. RESULTS: Discontinuation of dutasteride led to significant deterioration of LUTS, increased prostate volume, and increased PSA level. The repeated-measures analysis of variance showed that the changes in IPSS, prostate volume, and PSA level over time also differed significantly between groups 1 and 2 (p<0.001). CONCLUSIONS: Withdrawal of 5ARI during combination therapy resulted in prostate regrowth and deterioration of LUTS. The PSA level is also affected by the use of 5ARI. Therefore, regular check-up of the IPSS and PSA level may be helpful for all patients who either continue or discontinue the use of 5ARI.
5-alpha Reductase Inhibitors ; Humans ; Lower Urinary Tract Symptoms ; Male ; Oxidoreductases* ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia* ; Retrospective Studies

For valgus impacted four part fracture of the proximal humerus, surgical stabilization and early mobilization of the joint can produce the best clinical outcomes. But, we have experienced a case of conservative treatment and gained good clinical results. We have reported this case and included a review of the relevant literatures.
Early Ambulation ; Humerus ; Joints

In order to investigate wheter or not elastic dynamization by axial micromotion enhanced regenerate bone healing in distraction osteogenesis(callotasis), a unilateral external fixator, with which the magnitude of dynamization could be controlled, was applied to the tibiae of 12 Korean adult mongrel dogs, weighting approximately 35kg. Tibiae and fibulae of both sides were osteotomized at the proximal metaphysio-diaphyseal junction and fixed with unilateral external fixators. Distraction was started from the third postoperative day until 2 cm (10% of tibial length) of length gian was achived, at the rate of 0. mm twice a day. When 1 cm (5%) of lengthening was achieved, controlled elastic dynamization of 1 mm (group I), 2 mm (group II), and 3 mm (group III) in magnitude was allowed on left tibia. Right tibia was not dynamized until sacrifice, and served as a control for each group. Plain anteroposterior radiographs and measurements of bone mineral density(BMD) by dual x-ray absorptiometry(DXA) were obtained pre- and post-operatively. Relative ratio of BMD was calculated, dividing the BMD value measured in each period by the BMD value measured at the beginning of dynamization. Mechanical test was performed in uniaxial compression on an Instron machine. Following observations were made: 1. Plain anteroposterior radiography showed that at mid-consolidation phase (postoperative 50th day) the width of callus in the distraction gap increased significantly in all dynamization groups, as compared to their control groups(p < 0.05). However, there were no significant differences among the dynamization groups. 2. Both BMD and the relative BMD ratio of the distraction gap were higher in the dynamization groups than those in the their control groups throughout the study period(p < 0.05). However, there was no significant difference among the dynamizaion subgroup(p>0.05). 3. Axial Compression test revealed that the dynamization group had significantly increased stiffness, maximal load, elastic modulus, and strength, as compared to those of the control group(p < 0.05). In conclusion, controlled elastic dynamization effectively enhances regenerate bone healing in distraction osteogenesis of canine tibia, at 1 mm to 3 mm of magnitude.
Adult ; Animals ; Bony Callus ; Dogs ; Elastic Modulus ; External Fixators ; Fibula ; Humans ; Miners ; Osteogenesis, Distraction ; Radiography ; Tibia

BACKGROUND: Stomach cancer is the most common cancer in korea. Stomach cancer has been the focus of screening for early detection. Few data are available regarding factors associated with participation in cancer screening examinations in general population. This study investigated associations of age, sex, residence, economic state, occupation, education years, marital status, health state, faith for stomach cancer screening with participation in screening tests for stomach cancer. METHODS: To identify the factors associated with participation in the stomach cancer screening examinations, 2133 persons above 40 years old were surveyed in 1998. RESULT: Stastically significant (P<0.05) strong predictors of regular stomach cancer screening were as follows: (1) urban residence, (2) high economic state, (3) possession on faith for regular screening of stomach cancer. CONCLUSION: Especially, rural residents should be educated about importance of stomach cancer screening.
Adult ; Early Detection of Cancer ; Education ; Humans ; Korea ; Marital Status ; Mass Screening* ; Occupations ; Stomach Neoplasms* ; Stomach*